The evolution of courses in professional skills and perspectives for medical students.

A number of medical schools substantially revised their curricula in response to the GPEP Report, issued by the Association of American Medical Colleges in 1984. One of the most important areas of change has been in the way students are introduced to the professional skills and perspectives they will need to practice clinical medicine. A number of schools have recently developed interdisciplinary courses to accomplish this goal. Such courses may differ in scheduling, format, and focus, but they share a commitment to broadening skills and perspectives through experiential learning and small-group work. Most of these courses span the entire first two years of the curriculum, and some extend into the third and fourth years, blurring the line between the "preclinical" and "clinical" years. The near-simultaneous, largely independent introduction of major courses of this type into the curricula of some medical schools has gone largely unreported in the literature. This overview article discusses the origins of these courses and reviews the scope of the curricula now in place. Among the most comprehensive programs are those at Northwestern University, Oregon Health Sciences University, the University of California, Los Angeles, and the University of Nebraska, each of which is described and discussed in the following papers.